“So, the next best solution is mobile healthcare. And then one can go to a secondary healthcare centre, be it private or government, that doesn’t matter,” he said.

“But what’s happening today is when someone becomes sick in a village he or she directly goes to a tertiary care hospital. We have to fix the system. We need to reinvent and rewrite the blueprint,” said Dr Trehan.

The panel discussion was organised by IPE Global to announce the launch of its new venture Imperia Health, a hospital management company that aims to provide services to a network of hospitals for their complete hospital operations management through both an on site team and a backend support of experts.

Dr Trehan said, “Our government’s policy is so dismal we have to readjust ourselves. As medical professionals we cannot open a medical college; only a trust can do this, who can get land, fake hospital, faculty, patients etc.”

Dr Ranjit Roy Chaudhary, former member, Board of Governors, the Medical Council of India (MCI), who was participating as a delegate, said, “When I was a board member of the MCI, we tried to work on this (allowing private hospitals to open medical colleges) but a government medical college professor said, ‘We will not allow private hospital doctors to become teachers because they left academia for money. It will be on my dead body.’”

When asked what are the major challenges being faced by small hospitals in India, Shekhar Gupta said, “I am an outsider so don’t know exactly what challenges they are facing. But I can tell this much that most of them lack trust of their patients. You do a poll among patients and I am sure 90 per cent of them would say they don’t trust the doctors. They consider them as local crooks.”

“They need to build trust. I know a 12-year old child whose poor father had to pay Rs 800 to get the child treated of upset stomach. Later, I found out the child was put to ultrasound. Now, I don’t know why ultrasound was needed in this case,” he said, adding, “There are doctors who over promise and hold patients for long before referring.”

Gupta further said, “I don’t believe profitability is a problem of small hospitals. They simply don’t show their profit because they don’t want to pay taxes. They don’t give receipts. The flip side of not giving receipts is they are not giving proper prescriptions, diagnosis etc.”

Agreeing with Gupta, Shiv Khera said, “There are major-major trust deficit. If we are not making complaints that does not mean we are satisfied. According to a study, only 4 per cent of unhappy customers complain. It is because of trust that we go to a doctor or a mechanic who is miles away, bypassing many others on the way. So, we must work on building trust of our customers.”

Responding to this, Dr Randhir Sud said, “Lack of trust is because there are lack of procedures, standards, protocols etc.”

“The need is to educate the public and media can play a major role in this,” said Dr Trehan.

Gupta said, “The need is for transparency. Everything of a patient’s record should be put online so that they could be easily accessed. As a patient there is nothing more assuring than to have a proper file and a receipt.”

Dr Girdhar j Gyani said, “The fact is we have added very few district hospitals in the last 50 years but the population has multiplied many times. When there is an acute shortage of healthcare facility, quality will take a back seat.”

“In 2001, a study done in the US found that about 100,000 patients died due to medication errors and hospital acquired infections. But even today if we do such a survey in India to find out how many patients died in a year due to medication errors and hospital acquired infections, we will find none because we don’t measure,” according to Dr Gyani.

Making another point, Dr Gyani said, “In India, we never thought of bringing regulation in healthcare because till recently most of the hospitals were run by the government and the perception was that if it’s a government institution we don’t need regulation.”

“With the advent of private healthcare institutions, the need for quality accreditation became apparent. But even now, less than 200 hospitals in the country have got quality accreditation,” Dr Gyani said, adding, “There are nursing homes running in flats, emergency rooms on 3rd floor but we can’t close them because there will be chaos.”

Dr Trehan said, “I have never seen a more passive group of doctors than we have today. From time immemorial doctors had been leaders of the society. Earlier, doctors didn’t even have a stethoscope but still they enjoyed the trust of people. But today with all the modern technologies and skills we are so much bothered about ourselves that we have lost the larger picture.”

“If we read the Hippocratic oath once a month, we will become a better doctor,” he suggested.

“MBBS means you will never starve. Any business or government can fail but a doctor can still survive. We are privileged. It is only we who can cure us. Don’t think an outsider can do this for us,” Dr Trehan said, adding, “IMA (Indian Medical Association), DMA (Delhi Medical Association) should stop indulging in politics and should get our own house in order.”

Highlighting the importance of employee training, Shiv Khera said, “You might wonder, ‘why should I train my employee when he is any way going to leave for another organisation.’ But the point is if you don’t train your employees you run the risk of losing your customers. So ask yourself, what is worse, losing a trained employee or losing your customers?”

“The fact is bad news travel faster than good news. With untrained staff you lose your customers much faster. Also, if you train, the retention becomes better,” added Khera.

One comment

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